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(upbeat music) - Welcome to "Business Forward" I'm your host, Matt George, tonight's topic's gonna be a great one.

I've got a friend of mine on the show, Tom Feldman.

Tom is CEO of the Center for Health.

Welcome.

- Thanks for having me, Matt.

- Well, let's start with you, let's talk about you, are you from here?

- I'm not, originally from Buffalo, New York and then did my undergrad work at a university of Tennessee in broadcasting, actually.

- Really?

- Yeah and then got into healthcare management well I had an interest in healthcare management because of my parents both worked in healthcare and received my graduate degree from Indiana university, - That's what I thought, I thought you went to IU.

- And then made my way to Chicago.

Where I did a fellowship postgraduate at the children's Memorial back when it was in its old location.

And that's where met my wife, Nancy.

And we've been down here in Peoria for 20 years and it was not supposed to be forever, but turned out to be for 20 years and we have two kids, John and Charlie are 14 and almost 13.

And we love it here.

- Yeah, it's funny because most people think I'm from here.

I'm not, I actually moved here 21 years ago too.

So you're and you know, what brought you here?

Did the job bring you here?

- Yeah, so at the time an opportunity came up, friend of a friend knew someone that they were looking for, someone with some of the outside of the area expertise in physician practice management.

So I actually started at what was then Methodist running their, the Methodist medical group.

And I was there for about seven years.

And then I moved over to where I am today at the Center for Health.

- So you've been there probably 13, 14 years?

- Yeah, 13 years next month.

- So you're the CEO of the Center for Health and have been for, I guess, 13, 14 years, but talk about the company for a minute.

- Sure.

So the building is actually been there for 20 years out on 91.

- That's what I thought.

- But the company that I work with, work for is a joint venture LLC, where the OSF, the ministry owns roughly half.

And then there's a group of surgeon investors that own the other half.

And that company was started back in March of '07 and I came on in November of '08.

They were looking for more of a business type to work on some of their strategic aspects of it.

So we have that location and then we have another one across from the Civic Center, two room, OR, we do about 8,000 outpatient visits a year, multi specialty.

And so it's, there's, it's eyes, it's ortho, it's plastics, you name it, but anything that can be done outpatient, we got into total joints in the last year and a half, which has been great for, it's been great for everyone.

'Cause it's lower cost more efficient, and you don't have to go to the hospital.

And I've worked at both hospitals here in town, so I'm not knocking going to a hospital, but if you're not sick and you just need a procedure done, then, I mean, there's really no reason to have to go to one.

- All right so to put it simply, I need a, an outpatient procedure, I go to your place.

- You could, you could go to my place.

Yeah, you don't self-refer, self-schedule, at the Center for Health.

You come in through a surgeon office, but we have surgeons that work independent groups and employed docs that do procedures at the center.

- Well, this might sound dumb, but it's an ambulatory surgery center.

What does ambulatory even mean?

I don't even know what that means.

- Yeah.

So, I mean, basically it's outpatient, so it's yeah.

So it's not something that requires an overnight stay.

And so you're in and out.

And I mean, technically we're not even 23-hour, we're a hard stop at midnight, but no one sticks around past seven or eight O'clock usually even our total joint patients you'll come in and if you need a knee or a hip done, Matt, which you may soon, but yeah, but you could be in at seven o'clock for your procedure and you're walking out under your own power at one or two o'clock in the afternoon.

- That's crazy.

So I'm kind of winging this question here.

So it just made me think 15 years ago, that surgery might have been a four-day, three-day, I'm guessing overnight procedure.

Now it's just in and out.

- Yeah and it's really evolved pretty quickly.

And Medicare got on board in the last year-ish with reimbursing for that our commercial payers had done it for a couple of years prior to that.

But it really is, assuming you don't have any other comorbidities or anything else where, you'd be a higher risk patient, then it's much better to be in that situation or in our setting, because for one cost, I mean, we're much more reasonable.

Just our cost structure is a lot less, we're not running a 24-hour operation.

We don't have a huge bed tower.

- Overhead.

- Yeah, totally different structure there.

So we're able to deliver that, which benefits, not only the patient for co-insurances purposes, but employers who might end up being on the hook for some insurance premiums.

It helps the insurance companies.

And again, it gets the patient in and out with, with a lot less trouble.

- That's interesting.

So when COVID hit and surgeries were down, as a leader, how did you adapt to something like that?

Because earth just kind of shut off, didn't it?

- Yeah.

Well, so we stayed open, but we were doing emergent cases more than anything else.

And we really felt a need and a responsibility to keep our doors open in order to alleviate the pressure at the hospitals.

And so we were kind of a, I don't say a pop-off valve, but we were a place that patients could go get some things done that needed to be done, but not put that kind of pressure on the hospitals in town.

- I mean, was there a time as a leader that you sat there and maybe you're at home one night and said, our business is changing and we have to do this and this and this.

Did you have that aha moment?

- I think I had the aha moment that we all had to, we had to be responsible, but deliberate and stay on course and not panic, because I think the community needed us to be there for them.

- So same type of question, but how did your staff adapt?

Because, they've got to be sitting here, they're worried about their own families, are worried themselves, people coming in a lot of unknowns at the beginning of COVID.

- Yeah.

And there was, we're unchartered territory, no matter the industry and healthcare is not excluded from that.

But we obviously had the means to protect ourselves with PPE.

And we did switch over to higher grade masks and some other things, but we generally, we use universal precautions in any event anyway.

And so, I mean, I'm really pleased with the fact that during the pandemic, we had no situation ever, where we had an OR employee that tested positive.

So we were able to get, now we had a couple employees that had some vacations and many tested before they came back.

And so we have had some people that did have COVID, but no one on-premise in the, OR, and so it was a, knock on something here.

We're not out of the woods, but we we'd been pretty, pretty good about staying on top of that and monitoring.

- I mean, think about your business.

Cleanliness is key.

- Yeah.

- You got to be clean.

- Yeah, so we always operated in a sterile environment, when you go to places now where they're constantly wiping things down and doing the things that honestly we've been doing forever, anyway.

- So I was thinking about your business as I was prepping thinking about you last couple of days, and some of the direction this conversation was going.

And I thought there's not a lot of business out there where people actually probably a hundred percent walk in anxious.

Do you ever, have you ever thought that?

- Yeah, well, even myself, I don't like the healthcare setting.

I don't like hospitals, needles freak me out.

And so we, but we have a staff there that is very well-trained.

We actually bring in a child life specialist when we know it's gonna be a higher pediatric day to help with some of those patients as well.

And our staff does a really good job of keeping in mind that we do this every day, but for the person coming in the door, this is probably pretty new to them and might be their first time.

And so we try and provide the most comfortable environment possible.

- And I wanna give your staff credit because my mom was a nurse she's retired now, but a pediatric nurse for 40 some years.

And I always said, that the things that medical professionals do, especially nurses, 'cause I'm thinking about my mom is that, is special.

I mean, they do what a doctor does eight times 10, and I'm not no discounting what doctors do, but it always seemed like she was just constantly caring and she'd bring it home to dinner.

And it was who she was, just a compassionate person.

You have to have those people with compassion working for you.

- Yeah, 100%, they believe in it.

And they treat the patients as their own and they can be a little protective of them actually from time to time and which is great.

And I've always said, one of the best parts about being in healthcare, although I'm not clinical, I'm just on the business side, is that at the end of the day, I mean, we help people get better.

And we care for people and not all jobs, a lot of jobs are important, but it's sort of a nice takeaway that not only is our job important, but we're also doing something to help someone feel better or get healed.

And it's kind of icing on the cake.

- Yeah, as I've known a couple of employees that worked for you, the way I put it is they have passion for the job and compassion for everybody that works around them and with them.

And what's also interesting too is if you think about it, every day that some of your staff go in, they have to put that safety net around each person that comes in there because of being nervous or anxious or whatever it is.

- A hundred percent.

I mean, it's a team effort from the people that are at the front desk, I mean that's the first encounter that, that patient has to the time when that nurse walks them out to their car and that the discharge and everything in between, it's a complete team effort.

- I was telling you off before the show started about my son, he broke his thumb and we go in and we get... That customer service peace puts you at ease.

My son almost didn't even really care the fact that he wasn't gonna be able to play baseball for four to six weeks.

As a dad, you're sitting here, you're nervous.

And you're thinking all of these things, you've got two kids.

But that customer service peace puts you at ease.

- Yeah, for sure.

And what we've, you know, one of the things you asked, how we dealt with with COVID, we did have some restriction in terms of visitors and how many people could go back and how much time they could spend back there.

So again, that was another point in time where our staff had to step up a little bit, because those people that were there, it didn't have that, that family support that they would typically have waiting pre or post their procedure.

- So are you like a hospital in a sense where you still have to be accredited through Joint Commission or something like that?

- So we have a couple options, being in the ambulatory world.

We can either go with a group called the AAAHC, or you could use the Joint Commission.

I would say that AAC typically steer towards the AAAHC, because that's kind of what they're geared or known for.

We've maintained the Joint Commission accreditation, just because a lot of us are former hospital people anyway, and it's all we've ever known and the Joint Commission, I think, I won't say the standard is higher.

It's certainly more rigorous.

And we feel good about the fact that we've maintained our Joint Commission accreditation.

- It shows, it tells a story.

It really does it, and I remember great CEO, Debbie Simon.

- I know Debbie well.

- And Debbie would go Joint Commission on this date.

And I said, "Well, what is the Joint Commission?"

And she said, "It's the audit of audits."

but it makes you and your team be best in class.

- A hundred percent.

- Yeah.

Cool.

Are you having trouble finding employees like everybody else's right now, or do you just have a core team that's just set?

- So we have a good core, but we have had some turnover.

I won't say that we've, I know that the hospitals in particular have been having, I would say, having more trouble than we do, but we're keeping in mind that it's really not an apples to apples comparison, because when, if you're just talking about nursing as an example, I mean, we're not open on holidays and we're not open on the weekends.

We're there's not a third shift and there's no call.

So we're kind of, we actually, we get some of our best employees from hospitals where those nurses or those clinical folks are a little tired of that sort of regimen.

And then they come over.

We have had some issues with just like all employers in some of our clerical areas with, the unemployment piece out there that, the scenario of people being able to make more, to stay home than actually go back to work.

And so we've struggled a little bit there and had some turnover, but for the most part we've been kind of, we've been a place where actually we've been a, I call it a destination, but we've been able to definitely pick up some from the hospital.

- Interesting.

In a business like yours, it is about the experience for the patient.

And so I'm walking in and when I used to deal with programs that were related to cancer and I would sit here, and the thing that I noticed most was is the anxiety not about going in and seeing the doctor all the time, "How in the heck am I gonna pay for this?"

Or "I don't understand insurance."

Or that you guys help in the process too, right?

- Yeah, we do.

And it's individualized to the patient.

Some of them it's a little bit easier, but, and some, the surgeon offices help us before the patient even gets to us.

But I think our front desk, and certainly we have some financial folks in our billing office that will work with each patient to make sure they understand their deductible, their co-insurance et cetera.

And so, and we like to get all of that upfront and out of the way 'cause we don't want any big surprises when the patient presents and Hey, you owe us $500 or something.

And that's, we wanna avoid all of that.

- And it's key.

And I think it's, it's that navigating piece that's very important because I think of myself as someone that actually can figure this out pretty well.

And then I realized, no, I'm not, I'm sitting here going, "Why do I pay this?"

or "What am I doing here?"

So I think it's a big thing.

And I've heard that, I mean, your business helps in that.

And I think more healthcare facilities should think that way because some of them don't.

- Yeah, it's very, it can be very complicated and you get bills from different entities, even though you came to one location, you get three different bills because you might've had a pathologist, examine a specimen or might've gotten a plain film from a radiologist and that might be a bill.

So it can be a little overwhelming.

- When a surgeon or doctor, when they say you have privileges, does that mean they have the privilege to be able to perform a surgery or work in your facility?

- Yes.

- So how do you vet that?

- So we use, so that that's a very defined process and both the Joint Commission and CMS provide guidance for what they're looking for.

But we use the ministry St. Francis' CVO, their central verification office as sort of a clearing house to do some of the primary source verification, where they went to medical school, residency, that kind of stuff.

And then when they get to us, then we have a quality committee, we have a medical director, and then we review everyone's files, make sure that they have the proper requirements, competency, et cetera, to do a list of, and it's not just, okay, you've got privileges and now you can do whatever you want.

There's an actual list of, these are, well, and these are the procedures that you're able to do at our shop, and you just can't, an eye surgeon can't come in and fix your son's broken wrist.

And that's not the way it works.

So, we do have some parameters.

- Yeah, I was gonna use, a friend of mine, Dr. Kolettis at Illinois Eye, Illinois Eye will come in, and one of those surgeons may come in and use a room because it's easier and in and out more than what it is, what they typically do is that.

- Yeah, that's fair.

And so with Dr. Kolettis your example, I mean, he'll come in and we'll actually set up two rooms for him.

And he'll, what we call bouncing, he will go from patient is in one room, he'll perform that cataract procedure.

And then he'll jump in over to the other room where we've gotten a patient already ready for him.

And then he'll go back and forth to try and keep it efficient because a cataract procedure, even though you're there for probably a couple hours, actual skin to skin time is only about 10 minutes.

- Interesting.

- Yeah.

- That's pretty cool actually.

So what other procedures are done there?

I mean, you don't do major, major procedures.

Do you?

When I say major like heart.

- Now, well, we don't do anything cardiac related, but we do a fair amount of ENT otolaryngology procedures.

So sinus type things, tonsils, adenoids.

I mentioned the joints, we do quite a few other shoulder reconstructions, do a lot of, we could have fixed your son's broken wrist.

I don't know if he needed surgery or not.

- Thank God he didn't.

- We do not only just cataract cases with eyes, but we do some glaucoma procedures, some corneal transplants.

- That's a big one.

- Yeah, a lot of... On the general surgery side, we do a few colonoscopies a year, not a lot.

We do take out gallbladders, do a lot of hernia repair.

So anything you can do outpatient where we do pretty much the whole gamut.

- I'm a stats guy.

So like how many doctors have privileges at a place like yours?

- Yeah, so about 78 have- - About!

(laughs) specifically 78, that's possible.

- Privileges, yeah, and again, we do about 8,000 a year.

Now, some of those we do have minimums, but for the most part, I would say, I'd probably say there's 50 surgeons that make up the core of 90% of our business.

- So your kids have grown up here and you said earlier, you love the community.

What's great about our community middle, just middle Illinois in general.

- So I think there's a lot of convenience and ease and comfort to it.

Some of the past year or two, not withstanding and some of the things going around the community that we can all do a better job at making sure Peoria and central Illinois is doing the right things.

But it's a very inclusive, can be a very inclusive community.

Again, I, people ask me where I'm from, I say, I'm not from here, but at some point, I mean, I've been here 20 years and I'm very involved in the community, been on a lot of different, - Boards - Boards of charities and a lot of great groups in town.

And, obviously the children's home was fantastic.

I'm on the Epic Foundation Board, former park organization.

I used to do quite a bit of work with Easter Seals and the United Way.

I'm currently on the Dunlap school board.

So Nancy and I have integrated ourselves into the community.

And I mean, it, some days it feels like we've been here our whole lives.

- Well, what's cool about it is I think the same thing, I used to say, Danville and Champagne are my hometowns and I'm from Peoria now, this is where I live.

this is where my kids are.

And you've always been a good man and good for our community and appreciate.

This was an interesting conversation because I really didn't know much about it.

And I like deep diving in and kind of asking maybe simple questions, to the average person, they're not.

So thank you for coming on.

I appreciate everything you do for this community.

- Thanks for having me, Matt.

- Well, thank you.

I'm Matt George.

And this is another episode of "Business Forward".

(calm music) - Thank you for tuning in to "Business Forward", brought to you by PNC.

- [Man] It bothers me that I've learned so much more about all these surgeries-